Neuroendoscopic procedures in achievement of shunt independence: outcome analysis of 28 patients with shunt malfunction.

OBJECTIVE

The authors review their experience of the TV-controlled endoscopic technique in the treatment of shunt malfunction in 28 patients suffering from hydrocephalus.

MATERIAL AND METHODS

We treated 28 patients (6.6+/-1.2 years) with shunt malfunctions by a neuroendoscopic procedure. The number of reimplantations of the shunt systems prior to the neuroendoscopic procedure varied from 1 to 13. Duration of the shunt dependency has averaged to 42.7+/-8.1 months (range: 5-180 months). All procedures were performed with the Gaab I neuroendoscope and Gaab II miniature neuroendoscope. All patients presented with neurological signs and deficits. The follow-up period has averaged to 32.3+/-6.2 months (4-114 months).

CONCLUSION

Endoscopic surgery offers an effective technique in the surgical treatment of shunt malfunction. On the basis of our experience, the use of a neuroendoscopic procedure for shunt malfunction allows us to achieve shunt independence in 82.1% and shunt removal in 50.0%. The introduction of these methods is recommended in neurosurgical centers that are traditionally widely engaged in the treatment of hydrocephalus.